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214 Document No. 23. [Session
be traced to Tom Rickert, who spent a night at the place with a col-ored
family just after recovering from his attack. This colored
family contracted the disease. The mother cooked in a white family
and brought the disease to them in her clothes.
As before stated, the disease was seen in two forms, variola vera
and varioloid.
I can say, with the experience gained from the observation and
study of the sixty-two cases, that there is no distinguishing symp-tom
or symptoms of the onset of this disease other than that of the
eruption. The same symptoms are seen in the onset of malaria and
typhoid fevers and la grippe, and the similarity is seen in the pre-monitory
symptoms of dengue. The disease begins with a chill, fol-lowed
by high fever, intense headache, and pains in lumbar region
loins, and limbs. Nausea and vomiting are usually but not always
present. There may be a chill on three succeeding days, or several
chills in one day. The temperature rises rapidly, and may be as
high as 104 degrees on first day. It is usually continuous, with slight
morning remissions, or it may run a regular course as in typhoid
fever, the temperature curve following a regular diurnal variation.
The pulse is strong, full, and bounding, ranging from 100 to 140.
The face is red, eyes injected and the skin is usually dry. The pa-tient
is restless and distressed and when sleep is possible has fright-ful
dreams. Appetite absent ; thirst incessant ; constipation usually
present. Severe initial symptoms do not always precede a severe
attack of the disease. The tongue is usually moist and heavily
coated, the color ranging from brownish white to brownish yellow,
with the red papillae showing very much as in scarlet fever. It is
usually thick, heavy and swollen, often showing the impression of
the teeth. The severity of the symptoms, the headache, pain in
back and limbs, and the gastro intestinal disturbance may be so
modified by vaccination during the incubaticn period that the pa
tient will suffer little or no inconvenience and the ra^h itself may be
the (nly ncticeable symptcm. There are nc distinctive symptoms
of variola before the eruption makes its appearance. The eruption
is distinctive and the different forms in which it appears go to make
up the three varieties of smallpox, which are:
1. Variola Vera.
2. Variola Hsemorrhagica.
3. Varioloid.
Variola Vera is divided into four sub divisions, according to the
peculiar forms in which the eruption appears, as follows:
a. Discrete, in which each pustule is separate and distinct.
b. Corymbic, or where the pustules are in clusters or patches.
c. Coherent, in which the individual pustules come in contact.
d. Confluent, in which the pustules unite or flow together with-out
a line of division between them.

214 Document No. 23. [Session
be traced to Tom Rickert, who spent a night at the place with a col-ored
family just after recovering from his attack. This colored
family contracted the disease. The mother cooked in a white family
and brought the disease to them in her clothes.
As before stated, the disease was seen in two forms, variola vera
and varioloid.
I can say, with the experience gained from the observation and
study of the sixty-two cases, that there is no distinguishing symp-tom
or symptoms of the onset of this disease other than that of the
eruption. The same symptoms are seen in the onset of malaria and
typhoid fevers and la grippe, and the similarity is seen in the pre-monitory
symptoms of dengue. The disease begins with a chill, fol-lowed
by high fever, intense headache, and pains in lumbar region
loins, and limbs. Nausea and vomiting are usually but not always
present. There may be a chill on three succeeding days, or several
chills in one day. The temperature rises rapidly, and may be as
high as 104 degrees on first day. It is usually continuous, with slight
morning remissions, or it may run a regular course as in typhoid
fever, the temperature curve following a regular diurnal variation.
The pulse is strong, full, and bounding, ranging from 100 to 140.
The face is red, eyes injected and the skin is usually dry. The pa-tient
is restless and distressed and when sleep is possible has fright-ful
dreams. Appetite absent ; thirst incessant ; constipation usually
present. Severe initial symptoms do not always precede a severe
attack of the disease. The tongue is usually moist and heavily
coated, the color ranging from brownish white to brownish yellow,
with the red papillae showing very much as in scarlet fever. It is
usually thick, heavy and swollen, often showing the impression of
the teeth. The severity of the symptoms, the headache, pain in
back and limbs, and the gastro intestinal disturbance may be so
modified by vaccination during the incubaticn period that the pa
tient will suffer little or no inconvenience and the ra^h itself may be
the (nly ncticeable symptcm. There are nc distinctive symptoms
of variola before the eruption makes its appearance. The eruption
is distinctive and the different forms in which it appears go to make
up the three varieties of smallpox, which are:
1. Variola Vera.
2. Variola Hsemorrhagica.
3. Varioloid.
Variola Vera is divided into four sub divisions, according to the
peculiar forms in which the eruption appears, as follows:
a. Discrete, in which each pustule is separate and distinct.
b. Corymbic, or where the pustules are in clusters or patches.
c. Coherent, in which the individual pustules come in contact.
d. Confluent, in which the pustules unite or flow together with-out
a line of division between them.